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Pancreatic Neoplasms: HELP
Articles by Paul J. R. Banim
Based on 7 articles published since 2010
(Why 7 articles?)
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Between 2010 and 2020, Paul Banim wrote the following 7 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
1 Review Bridging clinic: The initial medical management of patients with newly diagnosed pancreatic cancer. 2019

Sreedharan, Loveena / Kumar, Bhaskar / Jewell, Anna / Banim, Paul / Koulouris, Andreas / Hart, Andrew R. ·ST Upper GI Surgery, East of England Deanery, UK. · Upper GI Surgery, Norfolk and Norwich Hospital, Norwich, UK. · Pancreatic Cancer UK, London, UK. · James Paget University Hospitals, Great Yarmouth, Norfolk, UK. · Academic Clinical Fellow in Gastroenterology, Norfolk and Norwich Hospital, Norwich, UK. · Gastroenterology, Norfolk and Norwich Hospital, Norwich, UK. ·Frontline Gastroenterol · Pubmed #31288251.

ABSTRACT: Pancreatic cancer is the 11th most common cancer in the UK and has the worst prognosis of any tumour with minimal improvements in survival over recent decades. As most patients are either ineligible for surgery or may decline chemotherapy, the emphasis is on control of symptoms and management of complications such as poor nutritional status. The time period between informing the patient of their diagnosis and commencing cancer treatments presents a valuable opportunity to proactively identify and treat symptoms to optimise patients' overall well-being. The 'bridging clinic', delivered by a range of healthcare professionals from gastroenterologists to nurse practitioners, can provide this interface where patients are first informed of their diagnosis and second supportive therapies offered. In this article, we provide a structure for instituting such supportive therapies at the bridging clinic. The components of the clinic are summarised using the mnemonic INDASH (Information/Nutrition/Diabetes and Depression/Analgesia/Stenting/Hereditary) and each is discussed in detail below.

2 Review Pain in Patients with Pancreatic Cancer: Prevalence, Mechanisms, Management and Future Developments. 2017

Koulouris, Andreas I / Banim, Paul / Hart, Andrew R. ·Norwich Medical School, University of East Anglia, Bob Champion Research Center, Norwich Research Park, Norfolk, NR4 7TJ, UK. a.koulouris@uea.ac.uk. · Norfolk and Norwich University Hospital, Gastroenterology, Colney Lane, Norwich, NR4 7UY, UK. a.koulouris@uea.ac.uk. · Norwich Medical School, University of East Anglia, Bob Champion Research Center, Norwich Research Park, Norfolk, NR4 7TJ, UK. · James Paget University Hospital, Lowestoft Rd, Gorleston-on-Sea, Great Yarmouth, NR31 6LA, UK. · Norfolk and Norwich University Hospital, Gastroenterology, Colney Lane, Norwich, NR4 7UY, UK. ·Dig Dis Sci · Pubmed #28229252.

ABSTRACT: Pain affects approximately 80% of patients with pancreatic cancer, with half requiring strong opioid analgesia, namely: morphine-based drugs on step three of the WHO analgesic ladder (as opposed to the weak opioids: codeine and tramadol). The presence of pain is associated with reduced survival. This article reviews the literature regarding pain: prevalence, mechanisms, pharmacological, and endoscopic treatments and identifies areas for research to develop individualized patient pain management pathways. The online literature review was conducted through: PubMed, Clinical Key, Uptodate, and NICE Evidence. There are two principal mechanisms for pain: pancreatic duct obstruction and pancreatic neuropathy which, respectively, activate mechanical and chemical nociceptors. In pancreatic neuropathy, several histological, molecular, and immunological changes occur which correlate with pain including: transient receptor potential cation channel activation and mast cell infiltration. Current pain management is empirical rather etiology-based and is informed by the WHO analgesic ladder for first-line therapies, and then endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) in patients with resistant pain. For EUS-CPN, there is only one clinical trial reporting a benefit, which has limited generalizability. Case series report pancreatic duct stenting gives effective analgesia, but there are no clinical trials. Progress in understanding the mechanisms for pain and when this occurs in the natural history, together with assessing new therapies both pharmacological and endoscopic, will enable individualized care and may improve patients' quality of life and survival.

3 Article Dietary Fiber and the Risk of Pancreatic Cancer. 2019

Koulouris, Andreas I / Luben, Robert / Banim, Paul / Hart, Andrew R. ·Institute of Public Health, University of Cambridge, Cambridge. · Department of Gastroenterology, James Paget University Hospital, Great Yarmouth, United Kingdom. ·Pancreas · Pubmed #30489447.

ABSTRACT: OBJECTIVES: High dietary fiber may protect against pancreatic ductal adenocarcinoma (PDAC). We investigated associations between fiber intake and the risk of PDAC using for the first time 7-day food diaries. METHODS: Participants in the European Prospective Investigation Into Cancer-Norfolk completed the 7-day food diaries at recruitment. The cohort was followed up for 17 years to identify those who developed PDAC. Participants were divided into quintiles of fiber intake, and hazard ratios (HR) were estimated with their 95% confidence intervals (CIs). Fiber was tested for effect modification of high red and processed meat intake and smoking and the risk of PDAC. RESULTS: No significant associations for any quintiles of intake (HR Q5 vs Q1, 1.08; 95% CI, 0.56-2.08) were detected with no trend across quintiles. A high-fiber diet modified positive associations between red and processed meats with the development of PDAC (HR trends, 0.89 [95% CI, 0.47-1.69] and 1.02 [95% CI, 0.55-1.88], respectively) but not those with lower fiber intake. Fiber intake did not modify the risk of PDAC in past and current smokers. CONCLUSION: The findings do not suggest that fiber protects against PDAC, although it may decrease potential deleterious effects of meats.

4 Article Dietary oleic acid is inversely associated with pancreatic cancer - Data from food diaries in a cohort study. 2018

Banim, Paul Jr / Luben, Robert / Khaw, Kay-Tee / Hart, Andrew R. ·James Paget University Hospital, Great Yarmouth, Norfolk, UK. Electronic address: paul.banim@jpaget.nhs.uk. · Institute of Public Health, University of Cambridge, UK. · Norwich Medical School, University of East Anglia, Norwich, UK. ·Pancreatology · Pubmed #30031691.

ABSTRACT: BACKGROUND: Dietary oleic acid may prevent pancreatic ductal adenocarcinoma (PDA) by reducing hyperinsulinaemia which can otherwise promote DNA damage and tumour growth. Results from previous epidemiological studies investigating oleic acid are inconsistent. This study aims to clarify the relationship between dietary oleic acid intake and the risk of developing PDA using nutritional information from food diaries plus published serum biomarker data from HbA1c. METHODS: 23,658 participants, aged 40-74 years, were recruited into EPIC-Norfolk and completed 7-day food diaries which recorded; foods, brands and portion sizes to calculate nutrient intakes. Serum HbA1c was measured at recruitment in 11,147 participants (48.7% of cohort). Hazard ratios (HRs) for quintiles of dietary oleic acid intake and serum HbA1c were estimated using Cox regression. Additional analyses were made according to whether body mass index (BMI) was greater or less than 25 kg/m RESULTS: 88 participants (55% women) developed PDA after a mean follow-up of 8.4 years (SD = 3.9) (mean age at diagnosis = 72.6 years, SD = 8.8). A decreased risk of PDA was associated with increased dietary oleic acid intake (highest vs lowest quintile, HR = 0.29, 95% CI = 0.10-0.81, P trend across quintiles = 0.011), with statistical significance maintained when BMI>25 kg/m CONCLUSIONS: The data supports a protective role of oleic acid against development of PDA in those with higher BMIs possibly through influencing hyperinsulinaemia. Oleic acid intake should be accurately measured in future aetiological studies.

5 Article Higher Meat Intake Is Positively Associated With Higher Risk of Developing Pancreatic Cancer in an Age-Dependent Manner and Are Modified by Plasma Antioxidants: A Prospective Cohort Study (EPIC-Norfolk) Using Data From Food Diaries. 2017

Beaney, Alec J / Banim, Paul J R / Luben, Robert / Lentjes, Marleen A H / Khaw, Kay-Tee / Hart, Andrew R. ·From the *Department of Gastroenterology, Norfolk and Norwich University Hospital NHS Trust, Norwich; †Department of Gastroenterology, James Paget University Hospital, Great Yarmouth, Norfolk; ‡Department of Public Health & Primary Care, University of Cambridge, Cambridge, Cambridgeshire; and §Department of Gastroenterology, Norfolk and Norwich University Hospital NHS Trust, Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, Norfolk, United Kingdom. ·Pancreas · Pubmed #28375948.

ABSTRACT: OBJECTIVE: Carcinogens in meat may be involved in pancreatic carcinogenesis. Meat intake was investigated using 7-day food diaries and according to factors potentially influencing carcinogenesis: age, cooking method, and antioxidants. METHODS: Twenty-three thousand one hundred thirty-three participants in the European Prospective Investigation of Cancer-Norfolk cohort study completed 7-day food diaries and were followed up. Meat intakes were compared with controls and hazard ratios (HRs) calculated. RESULTS: Eighty-six participants developed pancreatic cancer. If younger than 60 years at recruitment, all quintiles of red meat (Q1 vs Q5; HR, 4.62; 95% confidence interval [CI], 0.96-22.30; P = 0.06) and processed meat (Q1 vs Q5; HR, 3.73; 95% CI, 0.95-14.66; P = 0.06) were nonsignificantly positively associated, with significant trends across quintiles (HRtrend, 1.33; 95% CI, 1.01-1.77 and HRtrend, 1.37; 95% CI, 1.04-1.82, respectively). Red meat's effect was attenuated by higher, but not lower, plasma vitamin C (HR, 1.06; 95% CI, 0.69-1.63 vs HR, 1.84; 95% CI, 1.09-3.14) and for processed meat (HR, 1.07; 95% CI, 0.71-1.63 vs HR, 1.80; 95% CI, 1.10-2.96). A nonstatistically significant risk was observed for high-temperature cooking methods in younger people (HR, 4.68; 95% CI, 0.63-34.70; P = 0.13). CONCLUSIONS: Red and processed meats may be involved in pancreatic carcinogenesis.

6 Article Investigating Physical Activity in the Etiology of Pancreatic Cancer: The Age at Which This Is Measured Is Important and Is Independent of Body Mass Index. 2016

Noor, Nurulamin M / Banim, Paul J R / Luben, Robert N / Khaw, Kay-Tee / Hart, Andrew R. ·From the *Department of Medicine, University of Cambridge, Cambridge, United Kingdom; †Department of Gastroenterology, James Paget University Hospital, Great Yarmouth, United Kingdom; ‡Institute of Public Health, University of Cambridge, Cambridge, United Kingdom; and §Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom. ·Pancreas · Pubmed #26390426.

ABSTRACT: OBJECTIVES: There are plausible biological mechanisms for how increased physical activity (PA) may prevent pancreatic cancer, although findings from epidemiological studies are inconsistent. We investigated whether the risk is dependent on the age at which PA is measured and if independent of body mass index (BMI). METHODS: A total of 23,639 participants, aged 40 to 74 years, were recruited into the EPIC-Norfolk (European Prospective Investigation of Cancer) cohort study between 1993 and 1997 and completed validated questionnaires on PA. The cohort was monitored for pancreatic cancer development, and hazard ratios (HRs) were estimated and adjusted for covariates. RESULTS: Within 17 years, 88 participants developed pancreatic cancer (55% female). There was no association between PA and risk in the cohort (HR trend, 1.06; 95% confidence interval [CI], 0.86-1.29). However, in participants younger than 60 years, higher PA was associated with decreased risk (highest vs lowest category HR, 0.27; 95% CI, 0.07-0.99). Higher PA was not inversely associated when older than 60 years (HR trend, 1.23; 95% CI, 0.96-1.57). Including BMI in all models produced similar estimates. CONCLUSIONS: The reasons why PA in younger, but not older, people may prevent pancreatic cancer need to be investigated. Physical activity may operate through mechanisms independent of BMI. If this association is causal, 1 in 6 cases might be prevented by encouraging more PA.

7 Article Dietary antioxidants and the aetiology of pancreatic cancer: a cohort study using data from food diaries and biomarkers. 2013

Banim, Paul J R / Luben, Robert / McTaggart, Alison / Welch, Ailsa / Wareham, Nicholas / Khaw, Kay-Tee / Hart, Andrew R. ·Department of Medicine, University of East Anglia, Norwich, UK. ·Gut · Pubmed #22826513.

ABSTRACT: OBJECTIVE: To investigate whether the dietary antioxidants vitamins C and E, selenium and zinc decrease the risk of developing pancreatic cancer, for the first time using 7-day food diaries, the most accurate dietary methodology in prospective work. DESIGN: 23,658 participants, aged 40-74 years, recruited into the EPIC-Norfolk Study completed 7-day food diaries which recorded foods, brands and portion sizes. Nutrient intakes were calculated in those later diagnosed with pancreatic cancer and in 3970 controls, using a computer program with information on 11,000 foods. Vitamin C was measured in serum samples. The HRs of developing pancreatic cancer were estimated across quartiles of intake and thresholds of the lowest quartile (Q1) against a summation of the three highest (Q2-4). RESULTS: Within 10 years, 49 participants (55% men), developed pancreatic cancer. Those eating a combination of the highest three quartiles of all of vitamins C and E and selenium had a decreased risk (HR=0.33, 95% CI 0.13 to 0.84, p<0.05). There were threshold effects (Q2-4 vs Q1) for selenium (HR=0.49, 95% CI 0.26 to 0.93, p<0.05) and vitamin E (HR=0.57, 95% CI 0.29 to 1.09, p<0.10). The HRs of quartiles for antioxidants, apart from zinc, were <1, but not statistically significant. For vitamin C, there was an inverse association with serum measurements (HR trend=0.67, 95% CI 0.49 to 0.91, p=0.01), but the threshold effect from diaries was not significant (HR=0.68, 95% CI 0.37 to 1.26). CONCLUSION: The results support measuring antioxidants in studies investigating the aetiology of pancreatic cancer. If the association is causal, 1 in 12 cancers might be prevented by avoiding the lowest intakes.